How can medical diagnosis get us wrong? - with Jules Montague

[@nicholaswatson3896]

7 consultants, 3 hospitals and it was myself who correctly diagnosed my wife's chronic shoulder pain. Most were too arrogant to accept that I was right, so I had to fight to get them to conduct the correct tests and understand why they were wrong. It took 5 yrs, but they eventually accepted I was right. I also managed to get her referred for a specific nerve block based on my diagnosis, which to date is still the only procedure to provide her with complete pain relief.

[@ben_imaging]

Absolutely outstanding talk. Not only a hugely important topic but also fantastic storytelling.

[@stephenbedford1395]

I worked in a public hospital ED here in Australia for twenty-four years and I can vouch for her comment about the noise! Some days it would drive me nuts; at lunch I would often go and sit in the gardens around the campus just to get some peace and quiet, if only for half an hour.

[@kevinwilliams5873]

God bless you, the best step by step, cogent, useful, meaningful, talk I have listened to in years. You are a credit to your profession. I hope someone in the upper echelons of government has watched this presentation and is going to give you a position from which to implement the change you have plainly demonstrated need made. You are deserving of the Kings grace.

[@sollas3]

This is so upsetting but it really needed be shared. Thank you so much for sharing your work with the world.

[@TM-rk5dj]

Brilliant. Going to read her book 😊

[@tgwashdc]

Wonderful talk about how social biases invaded medical diagnosis historically. An eye opener to see the present clearly.

[@regix1964]

Nice to hear you speak out about this. This reminds me of the books of Robert Whitaker, who where of great help to me in my struggle with antipsychotics.

[@JimBob-um8fh]

Loved it. She was a great speaker.

[@jagmarc]

About mis-dx in general. It's like a train on the wrong track and the longer it travels the further away the destination. You won't get anywhere talking to anyone at all in any part of the process to alter anything. There'll wrong treatment for the wrong disease and in some cases withdrawing that treatment can create symptoms of a misdiagnosed disease 'coming back'. The only way to deal with a wrong dx is to go right back to the very very beginning at the very start and review the first data. Few want to do it. At the very beginning you'll very likely see a pivotal key point had been overlooked and or something had been interpreted out of clinical context. At that point forward the patient stuck with that dx like a typecast actor. Every test and followup will be based on the original diagnosis. Even creative manipulation of known defects in the system and of clinical protocol are utilised to justify a dx. Data will be selectively interpreted so it 'fits'. It's not just the medical profession that does this. As for the patient the disease in some cases can even actually evolve into what's been diagnosed (which neatly destroys evidence of misdiagnosis with it). Don't blame the doctors it's just human nature. We all know a car becomes more unreliable the more times a mechanic makes an intervention, the medical profession is no different…no one is perfect and pressure is on to deliver results in an uncertain environment.

[@jme_a]

An interesting talk. I'd be interested to hear how this can be tackled (may be covered in the book) because some of the diagnosis sound like things formulated so that law enforcement have something concise to put on a cause of death, rather than "well, they were acting this way, they were really hot and breathing heavily, seemed delusional and then died."

[@neilmarshall5087]

Definitely one of the 'bookmark & share where needed' videos.

[@maedilein6802]

Wonderful speaker and the subject is quite interesting.

[@santaclosed5062]

Very interesting presentation about how even medical diagnosis has been manipulated, altered and denatured by very political intentions. This reminds me Michel Foucault. I’ll definitively check your book.

[@prarthana62]

Brilliant!

[@idio-syncrasy]

Has a similar thing happened with CFS. A condition that was or even is often seen as psychiatric and often suffered by females.

[@michaelogden5958]

Fascinating.

[@bvol7256]

excellent presentation

[@davidviner5783]

What does ''get us wrong?'' mean?

[@Robespierre-lI]

The woman from Mozambique probably could benefit from a PTSD diagnosis and treatment. There's no need to think that it is necessarily at odds with her cultural rituals back home - and there's no need to think that the demonic possession rituals at home necessarily work. They might even do harm more often than good.

[@mariusvanc]

That's very culturally insensitive of you. All cultures are valid (well, except the european ones).

[@norman_5623]

I would like to see a study with strong evidence that psychological or medical treatment of PTSD has a long-term clinically significant result. I'm not sure that PTSD is a more scientifically valid diagnosis than demonic possession. The Cochrane reviews seem to have equivocal results. For example, Pharmacotherapy for post traumatic stress disorder (PTSD), Authors' conclusions The findings of this review support the conclusion that SSRIs improve PTSD symptoms; they are first‐line agents for the pharmacotherapy of PTSD, based on moderate‐certainty evidence. The NaSSA mirtazapine and the TCA amitriptyline may also improve PTSD symptoms, but this is based on low‐certainty evidence. In addition, we found no evidence of benefit for the number of participants who improved following treatment with the antipsychotic group compared to placebo, based on very low‐certainty evidence. There remain important gaps in the evidence base, and a continued need for more effective agents in the management of PTSD.

[@thedude8046]

Answer; they are being influenced by the big corporations.

[@tlxdell]

You didn't even finish half of the video before you commented this, maybe you're the one influenced by big corporations...

[@thedude8046]

🤑

[@historyfunnfacts9204]

realy good !! interesting buddy

[@biingyin5522]

So this is a book promotion.

[@loewenberg11]

One ill one pill 😊, seek instead the root cause 😉

[@ubik459]

the US medical system is in failure

[@hannavanderwat5689]

Laced drugs and experimentation. Hm.

[@tashlan4164]

Anyone else hear the annoying high pitched feedback when she is talking?

[@terranovarubacha5473]

Yes! And the pitch on the breathy 's' (esses?) was troubling for a while too. The talk was well worth the trouble though

[@jonr6680]

A pattern emerges of TEDX speakers flogging their books - also appearing now at RI! This one in particular sounds very worthy and plausible, but it's not a subject for a book is it? More a government enquiry! And a few anecdotes don't make a sweeping generalisation to systemic failure, more a sense of the imperfect state of where the human race is now. To give an analogy, people die in cars every day. People die of drug overdoses every day. Of obesity, heart disease, cancer. But they don't make news because they can't be blamed on someone. We accept the state of medicine is imperfect. This self publicist who pivoted her career away from medicine to 'journalism' doesn't make me applaud. I think of all the doctors etc who haven't done this, but just do the work that actually matters.

[@Robespierre-lI]

In a society where countless people make claims without any real knowledge or research to support their claims, the centuries old practice of inviting people who HAVE put the effort to carefully assemble knowledge in book form to present their findings in lecture is something we should embrace. I have no idea why you are sneering at it. You're being churlish

[@bryan__m]

She's not *proving* a sweeping failure based on a few anecdotes; she's using anecdotes to *describe* the sweeping failure.

[@cryptonaut1407]

thankyou be very careful my dear, and follow the money who profits the most and who in power has the most to lose 😉

[@savage22bolt32]

Too much talk about homosexuality. That wasn't even in the title.

[@Mcfreddo]

Why was that too much?

[@savage22bolt32]

@@Mcfreddo the talk is titled _how can medical diagnosis get us wrong_. I was expecting physical ailments, not psychological.

[@Mcfreddo]

@@savage22bolt32 Homosexuality isn't an ailment let alone a psychological one was the point and to talk about the abuse suffered, if you look at it like that directly?

[@traveel9409]

First!

[@andrewholdaway813]

Whoopi doo

[@JimBob-um8fh]

You're a legend.

[@holdenrobbins852]

Now do Covid and vaccine injury...

[@misterbonzoid5623]

Yawn

[@SarahH0g4n]

Mild

[@ZeroOskul]

To the Royal Institution... or Rhode Island: All possessive nouns and proper nouns in the English language, such as "Jules's", which is misappropriated as "Jules' " in the description of this video, end with a possessive ess EXCEPT "Jesus' " in the specific case of "Jesus Christ". So, if a person named Jesus happens to own a crucifix which annoys another person named Jesus, we might say: "Jesus is cross of Jesus's cross of Jesus' cross." You'll learn to write in English one of these days, RI, you're only the home and soul of the greatest minds and ideas in the history of England, and I see no shame or harm in helping you along as you work to get your legs under you. Maybe you should have a standard writing style manual of about thirty pages that explains how to write in English, and perhaps you should only allow people who can prove they have read it and do understand it to post text concerning the RI for public consumption, rather than just letting the person with the nicest set if pens have a go at it. We live in a primarily text-based world, now, so learning to communicate in text is of utmost importance to the furtherance of the RI as a source of wisdom and a place of knowledge for the future of all humanity. All the best! Ciao! ZERØ O'skül

[@SocktheWorm]

Is language not a game of communication? Does it not naturally change over time to reflect how people organically agree it should? Small changes over time lead to great changes. There was no dividing line between modern and Middle English, but a gradient of time. Why should we not then infer that there is no stopping point at all? I personally feel like prescriptivism in grammar is holding us back from being open in our communication with each other.